Shin Splints & Stress Fractures

Runners are susceptible to problems with the lower limbs because of the repetitive nature of their activity. Training errors such as overtraining, biomechanical problems, and poor footwear can all contribute to the development of shin splints and stress fractures.

Many athletes use the term "shin splints" to describe pain in the lower leg. The more appropriate medical term for shin splints is "tibial stress syndrome." It is thought to be caused by repetitive microtrauma of the muscles of the lower leg and their attachments to the bone. This is often associated with tenderness over the shin, lower leg pain, and pain when the toes or foot are bent downwards.

Some things that may contribute to the development of tibial stress syndrome include over-pronation of the feet and biomechanical problems of the knees and hips which increase the stress on the lower leg and ankle. Any of these factors, during running, can cause repeated traction on the muscle where it attaches to the bone.

Treatment for Medial Tibial Stress Syndrome involves changing the way you train, treating and correcting the biomechanical problems and an orthotic assessment when indicated. If untreated, tibial stress syndrome can progress and a stress fracture may develop.

Individuals with stress fractures complain of pain, exacerbated by exercise and partially relieved by rest. The problem will often be related to an increase in activity or training. A runner with a stress fracture is advised to stop running and cross-train for three to six weeks, using activities such as swimming, biking or running in water, as long as these activities cause no pain. Treatment will include correcting any training errors and correcting and treating any biomechanical factors. Custom orthotics may be necessary. In severe cases, a leg cast may be required. Remember that the average time for a fracture to fully heal is approximately 12 months, however, it is often safe to return to activity in six to eight weeks. Before you return to running (usually after three to six weeks), you should be free of pain for at least seven to 10 days while walking and x-rays should show that the bone is healing.

If you think you have medial tibial stress syndrome (“shin splints”) or a stress fracture of your tibia it is important that you receive the appropriate care as quickly as possible. This will allow you to better understand your condition and properly rehabilitate it. Begin with PRICE (pressure, rest, ice, compression, elevation). A visit to a health care provider familiar with sports injuries is advisable.  This can be your chiropractor, family physician or sports medicine doctor. It is important to receive some form of hands on therapy, preferably something that will decrease pain, normalize tissue perfusion and promote healing, i.e., medical acupuncture, micro-current and soft tissue therapies such as Active Release Technique® or sports massage may be helpful if an injured runner would like to promptly return to activity. Non-steroidal anti-inflammatories (NSAIDs) and pain medication is helpful during the first few weeks of an injury, BUT this does not fix the problem, it allows you to manage the discomfort while taking the appropriate steps to rehabilitate your body and prevent future injuries.